Organization · Type 2 NPI
Life Line Technologies, Inc dba Xstrememd
Occupational Health Nurse Practitioner · Broussard, LA
NPI number
1629915962
Active
Practice location
1028 Forum Dr
Broussard, LA 70518-8060
Fax (337) 704-2974
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Occupational Health Nurse Practitioner Primary | 363LX0106X | None listed |
Occupational Health Nurse Practitioner: Definition to come...
3 other providers at this address
About NPI 1629915962
Life Line Technologies, Inc dba Xstrememd's National Provider Identifier is 1629915962, issued on May 4, 2026. The primary taxonomy on file is Occupational Health Nurse Practitioner (363LX0106X), and the practice location is in Broussard, LA. The record was last updated on May 4, 2026.